PMID- 17854835
OWN - NLM
STAT- MEDLINE
DCOM- 20080408
LR  - 20071207
IS  - 0022-510X (Print)
IS  - 0022-510X (Linking)
VI  - 264
IP  - 1-2
DP  - 2008 Jan 15
TI  - Prior antiplatelet use and infarct volume in ischemic stroke.
PG  - 140-4
AB  - BACKGROUND: Conflicting data exist on the role of antiplatelet agents in reducing 
      incident ischemic stroke magnitude, but most prior studies used 
      clinically-assessed neurologic deficit as the index of stroke extent rather than 
      more precise volumetric measurements of infarct size. We assessed the relation of 
      premorbid antiplatelet use to initial diffusion-weighted MRI (DWI) lesion volumes 
      among acute ischemic stroke patients. METHODS: Consecutive patients presenting 
      within 24 h of ischemic stroke over an 18-month period were studied. DWI lesions 
      were outlined using a semi-automated threshold technique. Subjects were 
      categorized into two groups: antiplatelet (AP) or no antithrombotic (NA). The 
      relationship between prestroke antithrombotic status and DWI infarct volumes was 
      examined using multivariate quantile regression. RESULTS: One hundred sixty-six 
      individuals met study criteria: 75 AP and 91 NA patients. Median DWI volume was 
      lower in the AP group than in the NA group (1.5 cc vs. 5.4 cc, p=0.031). A 
      multivariable model (adjusting for age, history of transient ischemic attack, 
      admission temperature, admission blood pressure, admission serum glucose, stroke 
      onset to imaging interval, stroke mechanism, premorbid statin and 
      antihypertensive use) demonstrated smaller infarcts in the AP vs. NA group 
      (adjusted volume difference: -1.3 cc, 95% CI=-0.09, -2.5, p=0.037). Prior statin 
      use, no history of TIA, large vessel atherosclerosis and microvascular ischemic 
      disease stroke mechanism were also independently associated with reduced infarct 
      volume. CONCLUSIONS: Prior antiplatelet treatment is independently associated 
      with reduced cerebral infarct volume among acute ischemic stroke patients. 
      Premorbid statin use, TIA history and stroke mechanism also predict infarct 
      volume in ischemic stroke.
FAU - Ovbiagele, Bruce
AU  - Ovbiagele B
AD  - Stroke Center, Department of Neurology, University of California, Los Angeles 
      90095, USA. Ovibes@mednet.ucla.edu
FAU - Buck, Brian H
AU  - Buck BH
FAU - Liebeskind, David S
AU  - Liebeskind DS
FAU - Starkman, Sidney
AU  - Starkman S
FAU - Bang, Oh Young
AU  - Bang OY
FAU - Ali, Latisha K
AU  - Ali LK
FAU - Villablanca, J Pablo
AU  - Villablanca JP
FAU - Salamon, Noriko
AU  - Salamon N
FAU - Yun, Susan W
AU  - Yun SW
FAU - Pineda, Sandra
AU  - Pineda S
FAU - Saver, Jeffrey L
AU  - Saver JL
LA  - eng
GR  - 1K23NS054084-01A1/NS/NINDS NIH HHS/United States
GR  - P50 NS044378/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20070912
PL  - Netherlands
TA  - J Neurol Sci
JT  - Journal of the neurological sciences
JID - 0375403
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Brain/blood supply/*drug effects/pathology
MH  - Brain Infarction/*drug therapy/*pathology/prevention & control
MH  - Brain Ischemia/*drug therapy/*pathology/physiopathology
MH  - Female
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
MH  - Intracranial Arteriosclerosis/complications/physiopathology
MH  - Ischemic Attack, Transient/complications/physiopathology
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Microcirculation/physiopathology
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Prospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
EDAT- 2007/09/15 09:00
MHDA- 2008/04/09 09:00
CRDT- 2007/09/15 09:00
PHST- 2007/04/03 00:00 [received]
PHST- 2007/07/03 00:00 [revised]
PHST- 2007/08/08 00:00 [accepted]
PHST- 2007/09/15 09:00 [pubmed]
PHST- 2008/04/09 09:00 [medline]
PHST- 2007/09/15 09:00 [entrez]
AID - S0022-510X(07)00567-9 [pii]
AID - 10.1016/j.jns.2007.08.033 [doi]
PST - ppublish
SO  - J Neurol Sci. 2008 Jan 15;264(1-2):140-4. doi: 10.1016/j.jns.2007.08.033. Epub 
      2007 Sep 12.